Health is defined as a complete state of physical, social and mental well-being which entails ‘illness free days’. Better health is central to human happiness and well-being. It is beyond doubt that the good health status of any nation’s citizens makes an important contribution towards economic progress. A healthy citizen will live longer, be more productive and save more. Thus good health is critical for socio-economic development as it increases the marginal productivity of labour.
One of the best ways to ensuring a healthy life for somebody in his/her life span is having a firm health foundation at infancy; a role mainly played by breastfeeding mothers. While most people are aware that human milk provides excellent nutrition, many people are unaware of breastfeeding's other health benefits for babies and ultimately expose their children to potential health problems by formula-feeding their babies. This article explores the advantages of breastfeeding that millions of parents and would-be parents in South Africa, Africa and the rest of the world might not be aware of.
There is a model in Health Economics known as the Grossman model (1972). This is a dynamic model that takes into account how health decisions today affect health outcomes in the future. According to this model, people invest in health much like we think of investing in capital stock (Grossman, 1972; 1991). Health is taken as a stock and not a flow. People use inputs (diet, medical care, exercise, time) to produce an increment in health status (physical health, mental health). People therefore, care about their health both directly and indirectly because health helps them earn income, taking into account that healthier people tend to earn more and to live longer.
Health decays over time and people invest in health to increase their health “stock’’. If we are to apply this to breastfeeding as discussed in the succeeding paragraphs, it becomes apparent that mothers have the responsibility of investing in the health of their children and the nation by choosing to breastfeed as this choice will impact positively on the stock of health for the kids as they grow. A healthy workforce means a sound human capital base for any nation which ensures a high level of productivity at the workplace. In other words, the type of feeding chosen by mothers for their infants can to some extent determine the level of income that a family and ultimately a nation will earn. If high infant mortality rates are a function of a lack of proper breastfeeding as reported in various media, then one can conclude that families who choose not to breastfeed choose to reduce the stock of health, the time that their children are to survive, ultimately the income that they earn, the income that the nation will earn as well as the socio-economic welfare and progress of the nation.
Parents therefore need to take cognisance of the fact that behind every healthy-child and ultimately every healthy nation is a woman who reasonably and responsibly decides to participate in critical health-enhancing behaviours such as breastfeeding children against all odds. Breastfeeding on its own is regarded as a health-enhancing behaviour. Participation in this health enhancing behaviour not only influences the health of the newborn child, but that of the mother as well. Africa is one of the continents that for long had breastfeeding as a natural, religious and inherent cultural practice but with socio-economic and cultural dynamics; more and more contemporary women have over the years abandoned this noble practice in preference for the now popular infant formula milk.
There is need for nations to put in place mechanisms and frameworks that ensure the revival and resurrection of the old belief in the health and psychological benefits of breastfeeding for babies. Last month, Minister of Health, Aaron Motsoaledi, lamented the fact that breastfeeding had become a dormant practice in South Africa which could be one of the factors contributing to an increase in child mortality in the country. The Minister called for a general consensus on creating policies that would advocate for breastfeeding in South Africa. This call, in my opinion, is a call that applies to the whole of Africa where the practice of breastfeeding is considered ancient, conservative and for the poor. Clearly, one of the reasons why many countries in Africa are burdened by diseases is partially because of inadequate breastfeeding of infants.
It has been scientifically proven that breastfeeding has numerous psychological, biomedical, and social benefits. Some of the positive reasons cited for breastfeeding include: the superior nutritional and immunologic properties of breast milk; the maternal bonding that takes place during the breastfeeding activity; an overall feeling of empowerment and a ‘return to nature’; the association between breastfeeding and emotional, cognitive, and psychosocial development of the child; future academic success and intellectual ability of the breastfed child as well as sound mental health. Mothers and fathers need to understand that breast milk has been recommended to be having the right amount of fat, sugar, water and protein that a baby needs and is much easier for a baby to digest. Emanating from its high nutritional value, breast milk helps protect the baby from various infections.
According to the New York State Department of Health Breastfeeding Promotion Programme, (1995), breastfeeding reduces the risk of allergies, obesity and illnesses such as ear infections, diarrhea and respiratory infections in children. There is need for an immense promotion of exclusive breastfeeding for the first six months of life. Exclusive breastfeeding is important as it stimulates optimal milk production. Introduction of any other foods or fluids, including water, reduces the child’s demand on breast milk and may interfere with the maintenance of lactation ending with early termination of breastfeeding. When infants are given solids or even non-milk fluids, the prevalence of diarrhea is much greater due to contamination of the bottles or food.
The basis of the health production function is with a good health status for breastfeeding mothers and their breastfeeding babies. To ensure more lengthy and healthy days, great attention must be given to the proper breastfeeding of babies. Several tests have been made and studies done that reveal that human milk is the best food for babies since it contains the right amount of nutrients, in the right proportions, for the growing baby (Dermer and Montgomery, 1997).
The composition of human milk naturally changes as the baby grows to meet the baby's changing nutritional needs. It serves as the nutritional model for artificial baby milks, but none of these can match it. Studies also show that human milk is the baby's first immunisation as it provides antibodies which protect babies from many common respiratory and intestinal diseases, and also contains living immune cells.
First milk, colostrum, is packed with components which increase immunity and protect the newborn's intestines. Aniansson, G. et al (1994) argue that artificially-fed babies have higher rates of middle ear infections, pneumonia, and cases of gastroenteritis (stomach flu). Breastfeeding protects infants from developing immune system cancers such as lymphoma, bowel diseases such as Crohn's disease and celiac sprue, and juvenile rheumatoid arthritis, all of which are related to immune system function.
Exclusive breastfeeding, especially if it continues for at least six months, provides protection against allergies, asthma, and eczema and other gastro-intestinal infections (Howie et al, 1990). More and more research is showing that breastfeeding leads to optimal brain development and breastfed children have higher intelligence quotient (IQ) than those formula fed. Human milk has special ingredients like DHA (docosohexaenoic acid) and AA (arachidonic acid) which contribute to brain and retinal development (Bauer, G. et al l991).
The extent to which breastfeeding affects mothers' health is also rarely emphasised. Breastfeeding is good for mothers too! Not only that, but it is a joyful, relaxing experience. In addition, there are many direct health benefits to breastfeeding mothers. According to Brewer, M.M., et al. (1989), immediately after birth, repeated bursts of oxytocin released in response to the baby suckling cause contraction of the uterus that protects mothers from postpartum hemorrhage (bottle-feeding mothers get oxytocin intravenously immediately after birth, but for the next 24-48 hours during which risk of hemorrhage is highest, they're on their own).
Continued exclusive nursing (that is breastfeeding without added bottles of formula or solids) tends to delay the return of ovulation and menstruation and the delayed menses also decrease the mother's iron losses. When combined with improved iron absorption from the gut, the net effect and benefit (despite some iron use for breast milk production) is decreased risk of iron deficiency or anemia on breastfeeding mothers.
Another well-documented benefit of breastfeeding is more rapid and sustained weight loss on mothers. Breastfeeding on its own is a work out! Dewey, K. et al. (1993) argues that milk production uses up to 200-500 calories a day. The prolonged suppression of ovulatory cycles appears to be associated with significant long-term health advantages as well. Mothers who breastfeed for at least six months throughout their lifetime have a decreased risk of breast cancer, and similar reduced rates have been shown for ovarian and uterine cancers. Even being breastfed has been associated with decreased risk of breast cancer, over and above the fact that women who were breastfed themselves are more likely to breastfeed their own children.
There are also psychosocial benefits to breastfeeding mothers. Close skin-to-skin contact of the breastfeeding baby with the mother provides optimal nurturing and an almost automatic close emotional attachment. Suckling at breast optimises hand-to-eye coordination, especially with regular ‘side-switching’. There is evidence of hormonal effects of breastfeeding which may predispose a mother to closer bonding with her infant, a bond that will last into adulthood. Combined with the automatic skin-to-skin contact and closeness afforded by breastfeeding (something which bottle-feeding mothers have to work to duplicate), this could result in improved eternal bonding between mothers and their children.
Some may bring in the issue of the risk of mother to child transmission (MCT) of the HIV/AIDS virus during breastfeeding. While this risk is there and while pregnant and breastfeeding mothers need to take precautionary measure, the discussion done above reveals that there are very few reasons, particularly from the baby's point of view, to avoid breastfeeding. Some may recommend that mothers who are HIV positive not breastfeed; however, in many areas of the world, breastfeeding's known benefits outweigh the small risk of transmission from breast milk especially with the advent of the prevention of mother to child transmission mechanisms.
Few other medical conditions preclude breastfeeding, as there are many appropriate medications that are suitable for use in breastfeeding mothers such as Nevirapine. There is therefore no justifiable excuse for any mother not to breastfeed considering the vast advantages of breastfeeding discussed in this article.
- Takura Chamuka (MSc Economics, BSc Economics) is a Human and Economic Development Consultant/Researcher based in Johannesburg, South Africa. Contact details: (firstname.lastname@example.org). This article may not be published or reproduced without the consent of the author.
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